{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T09:37:09Z","timestamp":1780652229105,"version":"3.54.1"},"reference-count":33,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>The lateral aspect of the cerebellomesencephalic fissure frequently harbors vascular pathology and is a common surgical corridor used to access the pons tegmentum, as well as the cerebellum and its superior and middle peduncles. The quadrangular lobule of the cerebellum (QLC) represents an obstacle to reach these structures. The authors sought to analyze and compare exposure of the cerebellar interpeduncular region (CIPR) before and after QLC resection and provide a case series to evaluate its clinical applicability.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Forty-two sides of human brainstems were prepared with Klingler\u2019s method and dissected. The exposure area before and after resection of the QLC was measured and statistically studied. A case series of 59 patients who underwent QLC resection for the treatment of CIPR lesions was presented and clinical outcomes were evaluated at 1-year follow-up.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>The anteroposterior surgical corridor of the CIPR increased by 10.3 mm after resection of the QLC. The mean exposure areas were 42 mm<jats:sup>2<\/jats:sup> before resection of the QLC and 159.6 mm<jats:sup>2<\/jats:sup> after resection. In this series, ataxia, extrapyramidal syndrome, and akinetic mutism were found after surgery. However, all these cases resolved within 1 year of follow-up. Modified Rankin Scale score improved by 1 grade, on average.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>QLC resection significantly increased the exposure area, mainly in the anteroposterior axis. This surgical strategy appears to be safe and may help the neurosurgeon when operating on the lateral aspect of the cerebellomesencephalic fissure.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.7.jns222838","type":"journal-article","created":{"date-parts":[[2023,10,7]],"date-time":"2023-10-07T01:39:28Z","timestamp":1696642768000},"page":"1160-1168","source":"Crossref","is-referenced-by-count":7,"title":["Resection of the quadrangular lobule of the cerebellum to increase exposure of the cerebellomesencephalic fissure: an anatomical study with clinical correlation"],"prefix":"10.3171","volume":"140","author":[{"given":"Juan Leonardo","family":"Serrato-Avila","sequence":"first","affiliation":[{"name":"Department of Neurology and Neurosurgery, Universidade Federal de S\u00e3o Paulo, Brazil;"},{"name":"Department of Neurosurgery, Hospital General de Tlahuac, ISSSTE, M\u00e9xico City, M\u00e9xico;"},{"name":"Department of Neurosurgery, Hospital General de Tlahuac, ISSSTE, M\u00e9xico City, M\u00e9xico;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Alberto","family":"Paz Archila","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery, Universidade Federal de S\u00e3o Paulo, Brazil;"},{"name":"Laboratory of Microneurosurgery Anatomy, Universidade Federal de S\u00e3o Paulo, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Monroy-Sosa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital General de Tlahuac, ISSSTE, M\u00e9xico City, M\u00e9xico;"},{"name":"Center for Research and Innovation in Neurosciences, Higher School of Medicine, National Polytechnic Institute, M\u00e9xico City, M\u00e9xico;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian An\u00edbal","family":"Alejandro","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery, Universidade Federal de S\u00e3o Paulo, Brazil;"},{"name":"Laboratory of Microneurosurgery Anatomy, Universidade Federal de S\u00e3o Paulo, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos Devanir Silva da","family":"Costa","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery, Universidade Federal de S\u00e3o Paulo, Brazil;"},{"name":"Laboratory of Microneurosurgery Anatomy, Universidade Federal de S\u00e3o Paulo, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Cavalheiro","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery, Universidade Federal de S\u00e3o Paulo, Brazil;"},{"name":"Laboratory of Microneurosurgery Anatomy, Universidade Federal de S\u00e3o Paulo, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaan","family":"Yagmurlu","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Neuroscience, University of Virginia Health System, Charlottesville, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael T.","family":"Lawton","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feres","family":"Chaddad-Neto","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery, Universidade Federal de S\u00e3o Paulo, Brazil;"},{"name":"Laboratory of Microneurosurgery Anatomy, Universidade Federal de S\u00e3o Paulo, Brazil;"},{"name":"Department of Neurosurgery, Hospital Benefic\u00eancia Portuguesa de S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3 suppl","key":"b1","series-title":"Neurosurgery","first-page":"S7","article-title":"Cerebellum and fourth ventricle","volume":"47","author":"Rhoton AL Jr","year":"2000","unstructured":"Rhoton AL Jr. Cerebellum and fourth ventricle. 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